Monday, October 29, 2012

Two New Studies Point To Worsening Health Situation In Iraq’s Fallujah

The September 2012 issue of the journal Health had two
articles about the medical situation in Iraq’s Fallujah in Anbar province. One
was about infant mortality rates, “Perinatal and neonatal mortality in Fallujah General Hospital, Fallujah City, Anbar Province, west of Iraq,” and the
other was on cancer, “Incidence of cancer in Fallujah above 10 years age with over view of common cancers in 2011.” The two papers both found a worsening
health situation in the city. A likely culprit could be the U.S. invasion and
the intense fighting that took place in Fallujah. However, the reports were
very circumspect to point blame in that direction. “Incidence of cancer” for
instance, believed that the increased cases found in the study could be because
of better diagnosis, reporting, and changes in population, although the
military operations could be a cause as well. Likewise, “Perinatal and neonatal
mortality in Fallujah General Hospital” thought the decade long sanctions
deprived Iraq of the necessary medical equipment and money to maintain the
country’s health system. Whatever the speculation may be, both pieces found
more cancer and infant mortality rates in Fallujah since 2003, which is
troubling enough trends even if the root reason for them remains unclear.

(Wikipedia)

“Incidence of cancer in Fallujah above 10 years age with
over view of common cancers in 2011” found higher rates of the disease in the
city than in the rest of Iraq, and neighboring countries. The study looked at
all cases of cancer from January 1 to December 31, 2011 in Fallujah and three
of its sub-districts, excluding leukemia. This was the first look at the
disease in the city since the 2003 invasion. It got its data from the Fallujah
General Hospital, Al-Janabi Hospital, Amyrea Hospital, private health centers
in downtown Fallujah and three sub-districts, a histopathology lab, private
clinics, and the oncology center in Ramadi. Of the approximate 600,000 people
in those four areas, the report found cancer in 27.2% of them. That broke down
to an incident rate of 96 per 100,000 overall, with 92.6 for men and 99.4 for
women. Fallujah city center had the largest amount of cases at 128 per 100,000,
with the western district of Saqlawiya second at 82. The lowest rate was found
in the eastern district of Karmah at 50 per 100,000. The two most common forms
of the disease reported were breast and lung cancer. The overall rate of 96 per
100,000 was three times higher than that reported for the city in 2002, which
was 34.5 per 100,000. It was also higher than the rate for all of Iraq at that
time, 63 per 100,000. The same was true when comparing Fallujah to some other
countries in the region. In Qatar for instance, the cancer rate was 63.1 per
100,000, 67.2 in Jordan, and 71.7 in Saudi Arabia. Only Iran, at 98 per 100,000
for females, and 103 for males was worse. The study speculated on many possible
reasons for why such a high cancer rate was found in the city. The first was
the two Battles of Fallujah, which took place in 2004. The authors thought that
might be why there were much higher rates in the central area of the city, then
in its sub-districts. At the same time, there were many other possibilities.
Those included better diagnosis, improved reporting, and changes in the
population. With the paper only focusing upon the cases of cancer reported, no
direct correlation could be made with any of those causes.

Cancer Rates In
Fallujah And 3 Sub-Districts 2011

Central Fallujah 128 per 100,000

Saqlawiya 82 per 100,000

Amyrea 66 per 100,000

Karmah 50 per 100,000

Overall 96 per 100,000

Cancer Rates In
Fallujah vs Selected Middle Eastern Countries

Fallujah 96 per 100,000

Iran 100.5 per 100,000

Saudi Arabia 71.7 per 100,000

Jordan 67.2 per 100,000

Qatar 63.1 per 100,000

“Perinatal and neonatal mortality in Fallujah General
Hospital, Fallujah City, Anbar Province, west of Iraq” wanted to determine the
state of Fallujah’s health services after the U.S. occupation by looking at
infant mortality rates. It looked at data collected at the Fallujah General
Hospital’s intensive care unit from January 1 to December 31, 2010. The study
included 290 neonatal deaths and 64 stillbirths. Those established a perinatal
mortality rate of 50.3 per 1,000 live births, and a neonatal mortality rate of
41.5 per 1,000 live births. The latter was lower than the rate reported by the
hospital from 2007-2009, which was 57.3, but higher than the national rate in
2009 of 23 per 1,000 live births. Fallujah’s neonatal mortality rate was also
considerably higher than several neighboring countries including Qatar, 4 per
1,000, the United Arab Emirates, 5 per 1,000, Kuwait and Bahrain, 6 per 1,000,
Oman, 7 per 1,000, Lebanon, 8 per 1,000, Libya, 9 per 1,000, Tunisia and Saudi
Arabia, 12 per 1,000, Jordan and Egypt, 13 per 1,000, Iran, 19 per 1,000, Morocco,
23 per 1,000, Yemen, 32 per 1,000, and Djibouti, 35 per 1,000. Only Sudan at 41
per 1,000 was close. What troubled the authors was that Fallujah General
Hospital is one of the best in Anbar, and is known for its equipment and staff.
Despite that, it still had a very poor record of taking care of pregnant mothers.
In Europe and America, infant mortality rates have gone down, because of better
technology and treatments. The paper believed that the international sanctions
imposed on Iraq in 1990 for its invasion of Kuwait, and the eight-year
occupation by the United States caused a decline in the country’s health
services. Those two events deprived the country of the advances that occurred
in Europe and America, and can now be seen in many nations in the region. What
the authors advocated for was more spending on Iraq’s health care services, so
that it could make up for what it lost over the last twenty years.

Neonatal Mortality
Rate Fallujah vs Selected Regional Countries

Fallujah 41.5 per 1,000 live births

Sudan 41 per 1,000 live births

Djibouti 35 per 1,000 live births

Yemen 32 per 1,000 live births

Morocco 23 per 1,000 live births

Iran 19 per 1,000 live births

Egypt 13 per 1,000 live births

Jordan 13 per 1,000 live births

Saudi Arabia 12 per 1,000 live births

Tunisia 12 per 1,000 live births

Libya 9 per 1,000 live births

Lebanon 8 per 1,000 live births

Oman 7 per 1,000 live births

Bahrain 6 per 1,000 live births

Kuwait 6 per 1,000 live births

UAE 5 per 1,000 live births

Qatar 4 per 1,000 live births

These two papers were important to add scientific data to
Fallujah’s health situation. The city has been the focus of many news reports
for its poor state of affairs, but they were mostly based upon anecdotal
stories. These studies add specific data to that more general picture. They
found large numbers of cancer cases and infant mortalities, which were above
many other countries in the Middle East and North Africa. Those were disturbing
figures. The causes were pure speculation, because there was no attempt to make
a direct correlation between any included in the papers. Many articles have
pointed the finger at the two Battles of Fallujah in 2004. Those could very
well be the reasons why health has deteriorated in the city, but there are
other possibilities as well. The cancer report for instance, pointed to a
decline in spending for health services that occurred in the last twenty years,
while the mortality rate paper also pointed to better reporting and diagnosis.
Further studies will have to be made before a clearer picture emerges of what
has led Fallujah to have such poor health conditions.

2 comments:

Sorry, anonymous. I accidentally deleted your comment by hitting the wrong button! I agree however that there are probably other environmental factors that could contribute to the poor health in Fallujah.

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Musings On Iraq was started in 2008 to explain the political, economic, security and cultural situation in Iraq via original articles and interviews. I have written for the Jamestown Foundation, Tom Ricks’ Best Defense at Foreign Policy and the Daily Beast, and was responsible for a chapter in the book Volatile Landscape: Iraq And Its Insurgent Movements. My work has been published in Iraq via NRT, AK News, Al-Mada, Sotaliraq, All Iraq News, and Ur News all in Iraq. I was interviewed on BBC Radio 5, Radio Sputnik, CCTV and TRT World News TV, and have appeared in CNN, the Christian Science Monitor, The National, Columbia Journalism Review, Mother Jones, PBS’ Frontline, the Center for Strategic and International Studies, the Institute for the Study of War, Radio Free Iraq, Rudaw, and others. I have also been cited in Iraq From war To A New Authoritarianism by Toby Dodge, Imagining the Nation Nationalism, Sectarianism and Socio-Political Conflict in Iraq by Harith al-Qarawee, ISIS Inside the Army of Terror by Michael Weiss and Hassan Hassahn, The Rise of the Islamic State by Patrick Cocburn, and others. If you wish to contact me personally my email is: motown67@aol.com